Register for Winter Poly Wonderland January 25-29, 2019
Welcome to the Winter Poly Wonderland registration form! We're looking forward to seeing you.

If you have any difficulties in filling out this form, please contact us at or 703-755-0607.

A tent site or bunk is included in the basic registration fee, as well as all meals and programs. If you prefer not to camp or bunk and would like to upgrade to indoor accommodations in a cabin, cottage, Lodge, or motel room, please fill out the second page of this form.

Please be aware that all attendees of Winter Poly Wonderland must pre-register - we do not take walk-in campers.

Email address *
Group Discount Code
If you have received a Group Discount Code from one of your friends or someone in your network enter it here. See our group discount page for more information:
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Name *
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Legal Name *
Please give your name as it appears on your photo ID.
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What are your pronouns?
Feel free to select all that apply. Or none at all.
Phone Number *
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Alternate Phone Number
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Address - Street Name & Number *
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Address - City *
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Address - State/Province *
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Address - Zip Code *
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Address - Country *
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Are you 18 or Older? *
Contact Sheet Information *
We will be making a contact sheet for event participants - what contact information would you like included? (Note: you will be able to change your choices after you arrive at camp.)
Emergency Contact Name *
Please give us a person to contact in case of emergency, preferably someone who is not also attending this event.
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Emergency Contact's Relationship to you *
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Does this person know the nature of the event you are attending? *
Emergency Contact Phone Number *
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Arrival at Camp *
If you are a first time attendee at one of our events and will not be with us on Friday night and/or Saturday morning we will need you to attend a short orientation upon arrival. When do you plan to arrive? Please include the day and approximate timing.
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Departure From Camp *
When do you plan to leave? Please include the day and approximate timing.
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Please click on the price based on the number of days you will attend. *
Pricing includes all meals, all programs, and a bunk bed or a tent site, if camping. If you can reasonably afford to do so please consider paying higher than the base cost to go towards our scholarship fund. There are scholarship funds available for those truly in need. If you want to be at camp, we want to have you here! Contact us at and we'll work out a win/win.
Would you like to donate to our scholarship fund? *
If so please fill in an amount to donate below. If not simply put no.
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Set-Up and Take-Down
Extend your New Years experience by volunteering with friendly folx to help set up and take down our infrastructure! Volunteers contribute $20 for meals.
Do you need, or can you offer, a carpool?
If you need or can offer a carpool, where will you be coming from?
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Do you have a special diet? *
Meals will be delicious, healthy food with vegan and vegetarian options. With enough advance notice, we can also accommodate many special food needs. In addition, there is space to store personal food, and a small kitchen where those with special diets can prepare what they need. Please check the items that are true for you.
Special Needs
Do you have any special needs or medical/psychological issues the organizers should know about? If so, please give details here. (This information will be kept confidential within the organizing team.)
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Payment Information *
You may pay for the event either by credit card or by sending us a check or money order. If you select "credit card," you will be directed to a payment site on the next page. If you select "check or money order", please write down the total amount due. You will be directed to a site with information about where to send your payment.
Total Fees: *
Please add up your registration fee plus any other fees (Pre- and Post-Camp and/or scholarship donation) and enter the total here.
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